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. 2017 Jul 3;17(1):463.
doi: 10.1186/s12879-017-2561-z.

Cryptococcosis in patients with hematological diseases: a 14-year retrospective clinical analysis in a Chinese tertiary hospital

Rui-Ying Wang  1 , Yan-Qiong Chen  1 , Ji-Qin Wu  1 , Xuan Wang  1 , Ya-Hui Cao  1 , Hua-Zhen Zhao  1 , Li-Ping Zhu  2
Affiliations

Cryptococcosis in patients with hematological diseases: a 14-year retrospective clinical analysis in a Chinese tertiary hospital

Rui-Ying Wang et al. BMC Infect Dis. .

Abstract

Background: Cryptococcal infection has become a public health challenge globally. However, information about cryptococcal infection in patients with hematological diseases remains relatively rare.

Methods: HIV-uninfected cryptococcosis cases with hematological diseases admitted to Huashan Hospital from January 2001 to December 2014 were reviewed.

Results: In total, 33 cryptococcosis patients were enrolled, including 12 malignant and 21 non-malignant hematological cases. Twenty-six patients had central nervous system (CNS) involvement, which was observed more often in patients with non-malignancies than with malignancies (20/21 vs. 6/12, P = 0.001) Most patients (25/26) with CNS infection were confirmed by cerebrospinal fluid (CSF) culture or smear, and 100% (20/20) of them tested positive for the CSF cryptococcal antigen test. Eighteen out of 26 cryptococcal meningitis patients were treated with amphotericin B (AmB)-based therapy, 16 of them with AmB deoxycholate (d-AmB) and 2 patients with liposomal AmB. The clinical success rate was 55.6%. D-AmB was well-tolerated at 0.35-0.59 mg/kg/d (median 0.43 mg/kg/d) and only 12 patients had mild adverse events.

Conclusions: CNS cryptococcal infection was more frequent in patients with hematological non-malignancies, and cryptococcal antigen test as well as the CSF fungal culture or smear are suggested for early diagnosis. D-AmB could be used as an alternative therapy for CNS-infected patients with hematological diseases.

Keywords: Cryptococcal meningitis; Cryptococcosis; HIV-uninfected; Hematological diseases; Pulmonary cryptococcosis.

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Conflict of interest statement

Ethics approval and consent to participate

This study was reviewed and approved by the local medical Ethics Committee of Huashan Hospital, Fudan University, Shanghai, China. As this is a retrospective study, data was obtained through medical records and analyzed anonymously, and therefore informed consent of the participants was not required.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Distribution of cryptococcosis cases over 14 years. HM = hematological malignancies, HNM = hematological non-malignancies
See this image and copyright information in PMC

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